Individual provider Active NPI

Kimberly R Tibbs, MD

  • Internal Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1013968346
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39972 Issued in CO
Practice address
9480 Briar Village PT
Suite 200
Colorado Springs, CO 80920-7922
Phone
(719) 278-3627
Fax
(719) 623-2101
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 39972 CO Primary

Addresses

Primary practice location

9480 Briar Village PT
Suite 200
Colorado Springs, CO 80920-7922

Mailing address

1901 N Union Blvd
Ste 105
Colorado Springs, CO 80909-7200
Phone (719) 278-3627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39972COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interim Healthcare of Southeastern Colorado, Inc CurrentSince Jul 24, 2022 Accepting new patients
University of Cincinnati Physicians Company, LLC Internal Medicine Past Accepting new patients
Mountain View Medical Group, PC Internal Medicine Past Accepting new patients
Mountain View Medical Group, PC Past Accepting new patients

Locations

1901 N Union Blvd
Ste 105
Colorado Springs, CO 80909
Phone (719) 314-4868

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1928/brand/1/csg/62/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1013968346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N UNION BLVD",
            "address_2": "STE 105",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809097200",
            "telephone_number": "719-278-3627",
            "fax_number": "719-623-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9480 BRIAR VILLAGE PT",
            "address_2": "SUITE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207922",
            "telephone_number": "719-278-3627",
            "fax_number": "719-623-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBS",
        "first_name": "KIMBERLY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "39972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.